MedicaidPrior AuthMedium impact
BT2023178: Pharmacy updates approved by Drug Utilization Review Board December 2023
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, OB-GYN +3 more·Prior Authorization
Effective date
Feb 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for Non-SUPDL PA and Step Therapy (FFS only) and Testosterones, added Paragard IUD as preferred to the drug list, and established quantity limits for sennosides/docusate sodium tablets. All changes take effect February 1, 2024.
Action Required
By February 1, 2024: Billing team must update prior authorization processes for testosterone prescriptions and non-preferred drug requests for Indiana Medicaid FFS patients. Verify Paragard IUD will not require prior auth as it's now preferred. Implement quantity limit of 8 tablets/day for sennosides/docusate sodium 8.6/50 mg. Check updated PA criteria on Optum Rx Indiana Medicaid website before submitting requests.